Aging & Mental Health,
Год журнала:
2024,
Номер
unknown, С. 1 - 8
Опубликована: Авг. 26, 2024
Objectives
Various
dementia
risk
scores
exist
that
assess
different
factors.
We
investigated
the
association
between
Cardiovascular
Risk
Factors,
Aging,
and
Incidence
of
Dementia
(CAIDE)
score
modifiable
factors
in
Lifestyle
for
Brain
Health
(LIBRA)
a
German
population
at
high
Alzheimer's
disease.
Alzheimer s & Dementia,
Год журнала:
2023,
Номер
20(1), С. 615 - 628
Опубликована: Сен. 28, 2023
Abstract
INTRODUCTION
We
investigated
the
effectiveness
of
a
multidomain
intervention
to
preserve
cognitive
function
in
older
adults
at
risk
for
dementia
Germany
cluster‐randomized
trial.
METHODS
Individuals
with
Cardiovascular
Risk
Factors,
Aging,
and
Dementia
(CAIDE)
score
≥
9
aged
60
77
years
were
recruited.
After
randomization
their
general
practitioner
(GP),
patients
received
(including
optimization
nutrition
medication,
physical,
social,
activity)
or
health
advice
GP
treatment
as
usual
over
24
months.
Primary
outcome
was
global
performance
(composite
z
score,
based
on
domain‐specific
neuropsychological
tests).
RESULTS
Of
1030
participants
baseline,
n
=
819
completed
24‐month
follow‐up
assessment.
No
differences
regarding
(average
marginal
effect
0.010,
95%
confidence
interval:
–0.113,
0.133)
found
between
groups
follow‐up.
Perceived
restrictions
conduct
by
COVID‐19
pandemic
did
not
impact
effectiveness.
DISCUSSION
The
improve
performance.
Highlights
Overall,
no
effects
detected.
improved
health‐related
quality
life
total
sample.
In
women,
reduced
depressive
symptoms.
during
pandemic.
International Journal of Stroke,
Год журнала:
2024,
Номер
19(8), С. 838 - 856
Опубликована: Сен. 16, 2024
Worldwide,
around
50
million
people
live
with
dementia,
and
this
number
is
projected
to
triple
by
2050.
It
has
been
estimated
that
20%
of
all
dementia
cases
have
a
predominant
cerebrovascular
pathology,
while
perhaps
another
vascular
diseases
contribute
mixed
picture.
Therefore,
the
contribution
affects
20
currently
will
increase
markedly
in
next
few
decades,
particularly
lower-
middle-income
countries.
In
review,
we
discuss
mechanisms
cognitive
impairment
(VCI)
review
management.
VCI
refers
spectrum
pathologies
any
degree
impairment,
ranging
from
subjective
decline,
mild
dementia.
While
acute
decline
occurring
soon
after
stroke
most
recognized
form
VCI,
chronic
disease,
particular
cerebral
small-vessel
can
cause
insidious
absence
stroke.
Moreover,
disease
not
only
commonly
co-occurs
Alzheimer’s
(AD)
increases
probability
AD
pathology
result
clinical
but
may
also
etiologically
development
pathologies.
Despite
its
enormous
health
economic
impact,
neglected
research
area,
adequately
powered
trials
therapies,
resulting
proven
treatments.
Current
management
emphasizes
prevention
treatment
risk
factors,
evidence
for
intensive
hypertension
control.
Reperfusion
therapies
attenuate
VCI.
Associated
behavioral
symptoms
such
as
apathy
poststroke
emotionalism
are
common.
We
highlight
novel
strategies
hopefully
lead
new
course-modifying
therapies.
Finally,
importance
including
endpoints
large
cardiovascular
need
an
increased
focus
funding
important
area.
Alzheimer s Research & Therapy,
Год журнала:
2024,
Номер
16(1)
Опубликована: Июнь 13, 2024
Abstract
Background
Evidence
on
the
effectiveness
of
multidomain
lifestyle
interventions
to
prevent
cognitive
decline
in
older
people
without
dementia
is
mixed.
Embedded
World-Wide
FINGERS
initiative,
FINGER-NL
aims
investigate
a
2-year
intervention
functioning
Dutch
at
risk
individuals.
Methods
Multi-center,
randomized,
controlled,
trial
with
duration
24
months.
1210
adults
between
60–79
years
old
presence
≥
2
modifiable
factors
and
1
non-modifiable
factor
for
were
recruited
January
2022
May
2023
via
Brain
Research
Registry
across
five
study
sites
Netherlands.
Participants
randomized
either
high-intensity
or
low-intensity
group.
The
comprises
combination
7
components
(physical
activity,
training,
cardiovascular
management,
nutritional
counseling,
sleep
stress
social
activities)
product
(Souvenaid®)
that
could
help
maintain
functioning.
group
receives
personalized,
supervised
hybrid
consisting
meetings
(on-site
online)
individual
sessions
guided
by
trained
coach,
access
digital
platform
provides
custom-made
training
materials
selected
apps.
bi-monthly
online
lifestyle-related
health
advice
platform.
Primary
outcome
change
composite
score
covering
processing
speed,
executive
function,
memory.
Results
Within
17
months,
participant
recruitment
has
been
successfully
completed
(
N
=
1210;
mean
age:
67.7
(SD:
4.6);
64%
female).
Modifiable
commonly
present
baseline
physical
inactivity
(89%),
low
mental/cognitive
activity
(50%),
engagement
(39%),
hypertension
(39%)
high
alcohol
consumption
(39%).
body
mass
index
participants
was
28.3
4.2)
total
serum
cholesterol
5.4
mmol/L
1.2).
Conclusions
Baseline
clinical
measurements
showed
successful
sufficient
potential
prevention.
will
provide
further
insight
into
efficacy
adults.
Trial
registration
ClinicalTrials.gov
(ID:
NCT05256199)/2022–01-11.
Alzheimer s & Dementia,
Год журнала:
2024,
Номер
20(8), С. 5684 - 5694
Опубликована: Июль 5, 2024
Abstract
INTRODUCTION
Dementia
risk
scores
constitute
promising
surrogate
outcomes
for
lifestyle
interventions
targeting
cognitive
function.
We
investigated
whether
dementia
risk,
assessed
using
the
LIfestyle
BRAin
health
(LIBRA)
index,
was
reduced
by
AgeWell.de
intervention.
METHODS
Secondary
analyses
of
AgeWell
trial,
testing
a
multicomponent
intervention
(including
optimization
nutrition,
medication,
and
physical,
social,
activity)
in
older
adults
with
increased
risk.
analyzed
data
from
n
=
461
participants
complete
information
on
risk/protective
factors
comprised
LIBRA
at
24‐month
follow‐up.
Intervention
effects
components
were
generalized
linear
models.
RESULTS
The
scores,
indicating
decreased
follow‐up
(
b
–0.63,
95%
confidence
interval
[CI]:
–1.14,
–0.12).
particularly
due
to
improvements
diet
(odds
ratio
[OR]:
1.60,
CI:
1.16,
2.22)
hypertension
(OR:
1.61,
1.19,
2.18).
DISCUSSION
However,
several
did
not
improve,
possibly
requiring
more
intensive
interventions.
Highlights
according
scores.
Beneficial
are
mainly
changes
blood
pressure.
A
pragmatic
is
apt
reduce
an
at‐risk
population.
Alzheimer s Research & Therapy,
Год журнала:
2024,
Номер
16(1)
Опубликована: Июнь 22, 2024
Abstract
Background
Aim
of
this
study
was
to
detect
predictors
better
adherence
the
AgeWell.de-intervention,
a
two-year
randomized
multi-domain
lifestyle
intervention
against
cognitive
decline.
Methods
Data
317
group-participants
comprising
risk
group
for
dementia
(Cardiovascular
Risk
Factors,
Ageing
and
Dementia
(CAIDE)
score
≥
9;
mean
age
68.9
years,
49.5%
women)
from
AgeWell.de
were
analysed.
Regression
models
with
four
blocks
(sociodemographic,
psychosocial,
factors
chronic
conditions)
run
on
components
nutrition,
enhancement
social
physical
activity
training.
Adherence
each
component
operationalised
by
assessing
degree
goal
achievement
per
at
up
seven
time
points
during
period,
measured
using
5-point
Likert
scale
(mean
achievement).
Results
Increasing
negatively
associated
adherence,
while
higher
education
positively
predicted
adherence.
Participants
mental
state
(Montreal
Cognitive
Assessment
(MoCA)-score
>
25)
baseline
self-efficacy
adhered
better.
Diabetes
cardiovascular
conditions
not
whereas
smoking
affected
Highest
quitting
in
past
only
all
components.
Conclusion
identified
worse
Particularly
seems
be
considerable
influence
This
should
considered
when
designing
future
trials.
Trial
registration
German
Clinical
Trials
Register
(ref.
number:
DRKS00013555).
Engagement
in
cognitive
and
social
activities
can
potentially
preserve
abilities,
which
makes
their
promotion
a
promising
avenue
for
dementia
risk
reduction.
However,
insight
into
how
to
adequately
measure
engagement
these
is
necessary
precursor.
A
rapid
scoping
review
was
performed
search
relevant
articles
on
PubMed.
The
aim
obtain
an
initial
understanding
of
(a)
are
measured
research
that
investigates
protective
against
(b)
explore
what
extent
this
aligns
with
the
operationalization
preventive
interventions.
findings
show
across
58
studies,
questionnaires
were
mostly
used
activities.
wide
variety
items
themes
observed
including:
arts
crafts;
clubs,
groups,
communities;
exercising;
games
puzzles;
going
out;
household
tasks;
learning
education;
making
music;
multimedia
usage;
reading;
socializing;
work/volunteering;
writing.
There
considerable
variations
number
content
items,
ulitized
response
scales,
recall
periods,
methods
compose
scores.
Additionally,
interventions
stongly
focused
psychoeducation
(computerized)
training,
limitedly
reflect
operationalized
questionnaires.Many
researchers
investigate
effects
or
but
promote
concepts
completely
differently.
This
results
fragmented
insights
protective.
Clarifying
precisely
entail,
aspects
would
support
development
measurement
instructions
as
well
activities.Keywords:
Dementia,
Cognition,
Social
Participation,
Cognitive
Activities,
Activities
Alzheimer s & Dementia Translational Research & Clinical Interventions,
Год журнала:
2025,
Номер
11(1)
Опубликована: Янв. 1, 2025
Abstract
INTRODUCTION
The
societal
costs
of
dementia
and
cognitive
decline
are
substantial
likely
to
increase
during
the
next
decades
due
increasing
number
people
in
older
age
groups.
aim
this
multicenter
cluster‐randomized
controlled
trial
was
assess
cost‐effectiveness
a
multi‐domain
intervention
prevent
who
at
risk
for
dementia.
METHODS
We
used
data
from
multi‐centric,
two‐armed,
(
AgeWell.de
trial,
ID:
DRKS00013555).
Eligible
participants
with
increased
baseline
(Cardiovascular
Risk
Factors,
Aging,
Incidence
Dementia/CAIDE
Dementia
Score
≥
9),
60–77
years
age,
were
recruited
by
their
general
practitioners,
assigned
randomly
lifestyle
or
health
advice.
performed
analysis
perspective.
time
horizon
2
years.
Health
care
utilization
measured
using
“Questionnaire
Health‐Related
Resource
Use
Older
Populations.”
As
effect
measure,
we
quality‐adjusted
life‐years
(QALYs)
based
on
5‐level
EQ‐5D
version
(EQ‐5D‐5L).
calculated
incremental
ratios
(ICER)
acceptability
curves
(CEAC)
net‐benefit
approach.
Exploratory
analyses
considering
women
EQ
visual
analogue
scale
(EQ
VAS)
conducted.
RESULTS
Data
available
819
(mean
69.0
[standard
deviation
(SD)5‐level
4.9]);
378
treated
group
441
control
group.
caused
higher
(+€445.88
[SD:
€1,244.52])
gained
additional
effects
(+0.026
QALY
0.020])
compared
(the
difference
statistically
significant).
ICER
€17,149.23/QALY.
CEAC
showed
that
probability
being
cost‐effective
moderate,
reaching
59%
willingness‐to‐pay
(WTP)
€50,000/QALY.
exploratory
promising
results,
especially
female
subsample.
DISCUSSION
Considering
aspects
like
WTP
limited
horizon,
Highlights
first
German
randomized
(RCT)
evaluating
multicomponent
approach
against
decline.
found
favorable
ratio.
reached
78.6%.
Women
could
be
an
important
target
A
longer
is
needed.